Table 1. Clinical, Surgical and Seizure Data.
Patient | Age at DX (years) | Tumor Location | VF defect | Seizure type | AED | Duration: seizure to surgery (years) | Seizure control post surgery | Extent of 1st resection | Extent of 2nd resection | Extent of 3rd resection | Disease status at last follow-up |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 10.2 | Temp | QA | SP-Sens | Carbamazepine Levetiracetam | 3.8 | Resolved | GTR | – | – | NED |
2 | 5.1 | Front | – | CP | Carbamazepine | 1 | Resolved | GTR | – | – | NED |
3 | 9.2 | Temp | – | Absencee | Carbamazepine | 0.3 | Resolved | GTR | GTR | – | NED |
4 | 15 | Par | Normal | NA | Phenytoin | 5g | Resolved | NTR | – | – | SD |
5 | 16.2 | Temp | – | GTC | Phenytoin | 2 | Resolved | GTR | – | – | NED |
6 | 9 | Temp | QAc | Absencee | Carbamazepine | 1 | Resolved | GTR | GTR | GTR | NED |
7 | 13.7 | Temp-Par-Occ | QA | CP | Carbamazepine | 0.4 | Resolved | NTR | GTR | – | NED |
8 | 15.1 | Temp-Par | – | GTC | Levetiracetam | 0.0h | Controlled | NTR | – | – | SD |
9 | 5.5 | Temp-Par | HHd | CP → GTC | Carbamazepine | 0.8 | Resolved | GTR | – | – | NEDi |
10a | 6 | Temp | – | CP | Zonisamidef Oxcarbazepine | 1.5 | Resolved | STR | STR | – | SD |
11b | 11.6 | Front | Normal | GTC | Valproic acid Phenobarbital | 1.8 | Resolved | BX | GTR | GTR | NED |
Abbreviations: AED, antiepilepsy drugs; BX, biopsy; CP, complex partial; Front, frontal; GTC, generalized tonic clonic; GTR, gross total resection; HH, homonymous hemianopia; NA, not available; NED, no evidence of disease; NTR, near-total resection; Occ, occipital; Par, parietal; QA, quadrantanopia; SD, stable disease; Sens, sensory; SP, simple parietal; STR, subtotal resection; Temp, temporal; VF, visual field.
The patient was seizure-free for 4 years, then seizures recurred and progressed during the next 8 years until a second resection was performed because of radiologic progression.
The patient underwent biopsy, and after 10 days, definite surgery. Five months later, the patient developed seizures, but the MRI was negative for a tumor. Approximately 4 years later, surgery was performed on the epileptic focus; no tumor was found.
The patient was blind in one eye because of congenital glaucoma and had QA in the other eye.
The visual field test used was a confrontational test administered by a neurologist.
The diagnosis of absence seizure was based on retrospective history from family and patients that was taken after the surgery; no EEG was performed to confirm.
The patient failed 11 different AED until the second surgery, where he needed only 2 AED after second surgery for 2 years and was able to stop AED without recurrence of seizures.
The patient had CT shortly after surgery and it showed a a mass, but the family deferred surgery for 5 years.
The duration from seizure to surgery in this patient was only 2 weeks.
The patient died from a cause not related to his disease after last contact.